New Technique Keeps Donor Lungs Viable Longer: Study

FRIDAY, Nov. 18, 2016 -- A technique that allows lungs destined for transplants to be preserved longer works well, a new Canadian study finds.
The strategy, called ex-vivo lung perfusion (EVLP), allows preservation of lungs for up to 12 hours,...

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AbstractPurpose of ReviewThere is a shortage of lungs available to meet the needs of patient who require lung transplantation. Ex vivo lung perfusion (EVLP) has allowed for the assessment and reconditioning of extended criteria and high-risk donor lungs, allowing for an increased volume of lung transplants. Recently, an invested interest in the utilization donation after cardiac death (DCD) donors has surfaced, in which EVLP has played an important role.Recent FindingsClinical studies have shown that EVLP can recondition donor lungs that initially would be unacceptable for transplantation. In a recent study, the interventi...

Different mechanical ventilation settings are known to affect lung preservation for lung transplantation. Measurement of particle flow in exhaled air may allow online assessment of the impact of ventilation be...

ConclusionThe next several years will usher in significant changes in understanding and interventions focused on lung injury. This manuscript highlights applications of EVLP to clarify how this system can be used for basic and translational research.

Authors: Hsin M, Au T
Abstract
Lung transplantation is a proven treatment for selected patients with end-stage lung disease. However, the number of patients on the transplant waiting list far exceeds the number of available donor lungs, resulting in waiting list morbidity and mortality. The problem is further exacerbated by the low utilisation rate of available donor lungs, for fear of selecting a damaged lung and the resultant primary graft dysfunction. In the past decade, ex vivo lung perfusion (EVLP) has become part of standard lung transplant clinical practice in Canada and Europe, and it has been shown to impr...

We report the first case on the use of EVLP followed by separate transplantation in two different centres. The local organ procurement organization proposed the lungs of a 53-year-old non-smoker donor who died for cerebral haemorrhage. P/F ratio was 294 after lung recruitment manoeuvres. Oto score was 10. Two centres accepted the grafts for two single transplantations under the condition of EVLP evaluation. After usual retrieval, the bi-pulmonary block was transferred to Centre 1 and EVLP was run as previously described. At the end of the procedure the two lungs were evaluated separately and both judged suitable for transp...